CN1636525A - Surgical stapling instrument having articulation joint support plates for supporting a firing bar - Google Patents

Abstract

A surgical stapling and severing instrument particularly suited to endoscopic articulates an end effector by having a geared articulation mechanism that converts rotational motion from a handle portion. A firing bar longitudinally translates between the handle portion and the end effector. The firing bar head is thickened in order to present an undistorted cutting edge and engagement features to the opposing jaws of the end effector. The firing bar also advantageously includes a thinned or tapered proximal portion in the form of a strip or band that negotiates the articulation mechanism flexibility. To prevent buckling of the firing bar strip during firing, a pair of support plates adjustably flank the firing bar strip through the articulation mechanism. Various versions show resilient and spring engagement of each end of the support plate to distal and proximal sides of the articulation mechanism, as well as a resilient support plate.

Description

Surgical stapling instrument with the cradle head gripper shoe that supports frizzen

With reference to application

The present invention relates to four common unsettled and applications of submitting on the same day day with the application of owning together.The open integral body of each application applies for that titles are respectively for these four at this as a reference:

(1) Frederick E.Shelton IV, " having the taper frizzen " of Mike Setser and Bruce Weisenburgh application in order to increase the surgical stapling instrument of the flexibility of rotating;

(2) " stapling instrument that has the swivel that is used for the frizzen track " of Douglas B.Hoffman application;

(3) Kenneth.S.Wales Douglas B.Hoffman, " have can along the surgical device of longitudinal axis rotation " of Frederick.E.Shelton IV and JeffSwayze application; With

(4) " having the surgical device that rotates shifted laterally control " of Kenneth.S.Wales application.

Technical field

The present invention relates to a kind of surgical stapling instrument (surgical stapler instruments), this surgical stapling instrument applies the nail line organizationally, thereby can follow closely incised tissue between the line (staple lines) at those, the improvement of constituted mode that the invention still further relates to the improvement of stapling instrument and have the stapling instrument of hinge bar.

Background technology

Less otch can reduce postoperative recovery time and complication, therefore, compares traditional surgical cutting device, and people would rather use endoscope (endoscopic) surgical device.Therefore, endoscopic surgical device field is developed significantly, and surgical device can accurately be placed on the distal portion effector on the suitable surgery location, and the distal portion effector links to each other with trocar cannula.These distal portion effectors are handled tissue in many ways, to realize diagnosis and therapeutic effect (for example, inner cutter, grasper, cutter, stapling instrument, folder tucker, lane device, medicine/gene therapy transfer device and use the energy device of ultrasonic, radio frequency, laser etc.

The location end effector is subjected to the restriction of the trocar.Common these splanchnoscopy surgical devices comprise end effector and by the stock between the handle portion of doctor's operation, this stock can be inserted into desired depth, and the rotation of the longitudinal axis of distaff, thereby end effector is navigated to certain number of degrees.Along with the judicious layout of the trocar and the use of grasper, for example by another set of bobbin, this localized amount is enough usually.Surgical stapling and cutter sweep, for example at U.S. Patent number 5,465, described in 895 is example by the endoscopic surgical device that inserts and rotate successful positioning end portion effector.

According to the character of operation, wish further to adjust the position of the end effector of splanchnoscopy surgical device, and be not limited to insert and rotate.Especially, wish end effector is placed on the longitudinal axis transverse to the bar of surgical device.End effector is called " rotating (articulation) " relative to laterally the moving by convention of bar of device.This rotational positioning allows the doctor more easily to handle tissue in some cases.In addition, after rotational positioning advantageously allows endoscope to be positioned at end effector, can't help the bar overslaugh of surgical device.

When aforementioned nonrotational stitching and cutter sweep have very big effectiveness, and can in many surgical procedure, successfully use, need to improve the operation that their connect the ability of end effector, thereby make them that bigger clinical flexibility is provided in use.The one or more frizzens of the general use of rotating surgical device, these frizzens vertically move in assembly axis, and to excite nail from tube, cut the tissue between the innermost nail line.The control that common problem is the swivel frizzen of these surgical devices.At the swivel place, end effector is in the vertical away from this bar, so that when being rotationally connected, end effector and bar can not collide.This ditch must be filled backing material or structure, with when single or multiple frizzen is subjected to vertically triggering load, prevents the crooked joint that breaks away from of frizzen.People need is by the swivel guiding and supports single or multiple frizzen, and swivel bending when end effector connects.

U.S. Patent number 5,673, that has described that a kind of elasticity or plastic material form in 840 can crooked swivel, and this material is in flexible tab or " crooked neck " bending.Frizzen supports and guiding by the hollow pipe in the crooked neck.Crooked neck is the part of interlock shutoff device, and when being engaged in tissue and closing, this bending neck can be with respect to end effector, and bar and frizzen are done longitudinally and moved.Then, when triggering stitching and cutting and organizing, frizzen vertically moves in crooked neck.

U.S. Patent number US5, described in 797,537 a kind of around bolt rotate swivel, be better than in the crooked joint bent around.In this device, frizzen supports between a pair of spaced apart supports plate, this gripper shoe one end connecting rod, and the other end connects end effector.In two connections at least one is slidably to connect.Support plate runs through the swivel near the flexible drive parts in the rotational plane, thus when most advanced and sophisticated in a direction when its arrangement position connects, gripper shoe is passed through the ditch bending in the rotational plane, and flexible frizzen is against this gripper shoe bending.U.S.'s surgery patent No. 6,330,965 has been instructed the use of support plate, and this gripper shoe is fixedlyed connected with bar, and can be slidingly connected with end effector.

Although known gripper shoe leads by swivel, believe that its performance can improve.For example, when triggering,, often require the acceleration that frizzen can be rapid in order to guarantee that enough power comes incised tissue effectively.Rigidly connected support plate relatively directly, allows frizzen to penetrate from swivel rapidly in response.As another example, require equipment no matter whether to use under the situation of rotation in design, all running in the same way.Apply the triggering power of variation if desired, increasing frictional force during connection can bring inconvenience and the patient is divert one's attention to the doctor.

So, the surgery equipment mechanism being improved linkwork have significant need, this surgical device mechanism is by the support of swivel raising to frizzen.

Summary of the invention

The present invention has overcome other defective above-mentioned and prior art, a rotating surgical device (articulating surgical instrument) is provided, this device drives end effector, and one vertically transmits trigger mechanism preferably passes the linkwork support by lateral bolster fagging (flanking support plate).For the emission load on the better response trigger mechanism, an end of each support plate or multiterminal all join on the side of linkwork with elasticity or spring, can also avoid the trigger mechanism bending like this.

In an aspect of of the present present invention, surgical device has the control handle of action that rotates (articulation motion) and trigger action (firing motion), and these two actions all are delivered to linkwork by bar.This linkwork response flexure operation makes the longitudinal axis rotation of end effector from bar.Trigger mechanism response trigger action, and for moving through the coupling of linkwork and end effector.A pair of gripper shoe is crossed over to rotate and is positioned at the trigger mechanism side, and each gripper shoe comprises the end that flexibly joins in the frame slot that forms in the rotation system, is used for assisting the trigger mechanism bending that prevents to break away from linkwork.Like this, the end effector of various arresting diagnosis or therapeutical effect can be integrated in the rotating surgical device, and can be in the bending of rotating mechanism, even triggering power is very high and reduce to be used for the size of components of endoscope.

Another aspect of invention, surgical device have and are used for producing trigger action, closing motion and rotational action handle portion, and each action all drives by bar.The rotating mechanism response rotational action that is connected with the bar far-end end effector of swaying.End effector comprises and the coupled elongated channel of straight-bar that coupling elongated channel and response are from the chopping block (anvil) of the closing motion of bar with swaying.Trigger mechanism has the margins of excision of the far-end existence of vertically holding between elongated channel and chopping block.Linkwork is by the bar elongated channel of swaying of response rotational action.A pair of gripper shoe is positioned at the both sides of trigger mechanism, strides across linkwork, and each gripper shoe comprises the end that flexibly joins in the frame slot that forms in the rotation system.Thereby, even improved stitching can be in conjunction with high load, the flip flop equipment that also can not cause triggering power obviously to increase of triggering of opposing when being connected with cutter sweep.

These and other objects of the present invention and advantage will be described by drawing and description.

Description of drawings

Combine and be the part of description with description, and described embodiments of the invention, and the detailed description of embodiment will provide below, the explanation to the principle of the invention will be provided with above-mentioned basic description of the present invention accompanying drawing together.

Fig. 1 is the perspective view of the nonrotating state of rotating surgical device.

Fig. 2 is the perspective view of the rotary state of rotating surgical device.

Fig. 3 is the perspective view of the end effector of opening of Fig. 1,2 rotating surgical device.

Fig. 4 is the side cross-sectional view of end effector of Fig. 3 of surgical instruments shown in Figure 1, and this part is normally exposed a nail tube part along the line 4-4 on Fig. 3, but also shows the frizzen of centrage longitudinally.

Fig. 5 is the side view of end effector after frizzen triggers fully shown in Figure 4.

Fig. 6 is the side cross-sectional view of the handle portion of the near-end that comprises the surgical device that rotates control shown in Figure 1.

Fig. 7 is the perspective exploded view of the handle portion of surgical device near-end shown in Figure 1.

Fig. 8 is that the distal portions of handle portion of surgical instruments of Fig. 1 is downward from the right side, perspective view forward, and this device part excision is to show rotation controling mechanism.

Fig. 9 makes progress from the right side for the distal portions of the handle portion of Fig. 8, perspective view backward, and this device part is excised with the demonstration rotation controling mechanism, and has the rotation control handle of decomposition.

Figure 10 is the top perspective of gear tubes linkwork of surgical device of having removed Fig. 1 of triggering and frame part.

Figure 11 is the perspective exploded view of apparatus part of surgical device that comprises Fig. 1 of gear tubes linkwork.

Figure 12 is the cross-sectional top view of Figure 11 spur gear linkwork.

Figure 13 is the cross-sectional top view of the rotational support plate of prior art.

Figure 14 is the cross-sectional top view of the rotational support plate of Figure 13 at rotary state.

Figure 15 is the cross-sectional top view of the gripper shoe of surgical device shown in Figure 1, and gripper shoe is connected to spring and the single degree of freedom end is arranged.

Figure 16 is the cross-sectional top view of the gripper shoe of Fig. 1 surgical device, and gripper shoe is connected to spring and the single degree of freedom end is arranged.

Figure 17 is the cross-sectional top view of the gripper shoe of surgical device shown in Figure 1, and the gripper shoe assembly has spring finger and single degree of freedom end.

Figure 18 is the perspective view of the gripper shoe that spring finger and single degree of freedom end are arranged of Figure 17.

Figure 19 is the cross-sectional top view of gripper shoe of the surgical device of Fig. 1, and gripper shoe is connected to spring and two free ends are arranged.

Figure 20 is the cross-sectional top view of gripper shoe of the surgical device of Fig. 1, and gripper shoe is connected to spring and two free ends are arranged.

Figure 21 is the cross-sectional top view of the gripper shoe of surgical device shown in Figure 1, and gripper shoe has spring finger coupling and two free ends.

Figure 22 is the cross-sectional top view of the elastic supporting plate of surgical device shown in Figure 1.

Figure 23 is the decomposition diagram of a pair of gripper shoe of surgical device shown in Figure 1, and gripper shoe is connected with the frizzen bearing.

Figure 24 is the exploded view of low friction support plate 460,462.

The specific embodiment

With reference to the accompanying drawings, identical in the drawings Reference numeral is represented identical assembly, and Fig. 1-3 shows a kind of surgical device, in the embodiment that describes, this surgical device refers to a kind of surgical stapling andcutter sweep 10, and this surgical device can be realized distinct advantages of the present invention.Particularly, the size of surgical stapling andcutter sweep 10 can be adjusted, so that when undergoing surgery for patient, the surgical stapling and the cutter sweep of as shown in Figure 1 nonrotating state is inserted into surgery location.As shown in Figure 2, in case theend effector 12 thatlinkwork 11 is connected with far-end is inserted by sleeve channel,linkwork 11 just can carry out remote rotation by pivoting controller 13.Therebyend effector 12 can arrive the organ back, or as required from an angle near organ.For example, trigger mechanism is depicted as E beam frizzen 14 (shown in Fig. 3), the nipped tissue of E beam frizzen 14 cuttings, and engage long-channel 16 and pivotally connectedchopping block 18.

Surgical stapling andcutter sweep 10 comprise thehandle portion 20 that is connected toapparatus part 22, and this apparatus part also comprisesbar 23 and theend effector 12 that far-end stops in the linkwork 11.Handle portion 20 comprisespistol grip 24, and wherein the doctor holds with a firm grip towardshandle 24 in the mode that pivots andcloses trigger 26, makes trigger clamp or close towards the long-channel 16 of end effector 12.Trigger trigger 28 in the more lateral ofclosing trigger 26, and hold with a firm grip in the mode that pivots, organize stitching and cutting and make whatend effector 12 was clamped by the doctor.Press organ that release-push 30 with release clamp thereafter.

Bar 23 outmost closedcover 32 responses and closed longitudinally translation oftrigger 26, pivotally to close chopping block 18.Especially, (inlinkwork 11 parts as seen)frame 34 supports indirectly byapparatus part 22 aboutclose cover 32 distal portions or the closedloop 33 of linkwork 11.Onlinkwork 11, the proximal part or the blanked-offpipe 35 ofclosing cover 32 communicate with distal portions (closed loop) 33.Frame 34 makes it possible to connect in a plane by thelinkwork 11 flexible long-channels that are connected to.Theframe 34 also support of longitudinal sliding motiontriggers driver part 36, and this element is communicated with trigger action from triggeringtrigger 28 to frizzen 14.Only show thefrizzen 14 thattriggers driver part 36 among Fig. 3, but the relevant various forms that triggers thevarious control linkworks 11 ofdriver part 36 can be described in more detail below.

Should recognize that term " near-end " refers to the position that relative doctor holds the device handle here with " far-end ".Therefore,end effector 12 is far away andhandle portion 20 is near.It is to be further appreciated that for convenience with clear, here about the relevant spatial term of accompanying drawing use, as " vertical " and " level ".Yet surgery device is used for many directions and position, and these terms should not be restricted.

E beam frizzen (E-Beam Firing Bar)

Fig. 3-5 shows and adoptsE beam frizzen 14end effector 12 to realize many functions.In Fig. 3,frizzen 14 allows unspent nail box 37 to be installed in the long-channel 16 in proximally-located.Particularly, it is one recessed that thetop bolt 38 offrizzen 14 is positioned at, the recessed plate bag 40 that is depicted as, and its allowschopping block 18 can be repeated to open and close.As shown in Figure 4,, enter chopping block groove 42 longitudinally,frizzen 14 is advanced engage with choppingblock 18 by makingtop bolt 38 along with end effector is closed.Minimum bolt, or it is surperficial by makingfrizzen 14 penetrating viagrooves 45 engage hanging down of long-channel 16 to trigger pole cap 44.Middle bolt 46 is sliding engaged to the upper surface of long-channel 16, with 44 combineds effect of triggering pole cap.Therefore, when triggering,frizzen 14 is affirmedspaced ends effector 12, thereby can solve the problem of contraction (pinching) when clamping is organized in a small amount and clamp the problem of being out of shape when organizing too much when clamping.

When triggering, the margins of excision that is present in far-end 48 between the top offrizzen bolt 38 andmiddle bolt 46 enters the vertical channel 49 of the nail box 37 that is present in near-end, the tissue of clamping between nail box 37 and thechopping block 18 that is cut.As shown in Figure 4,middle bolt 46 is actuated nail box 37 by the triggering groove that enters in the nail box 37, upwards enter the camming that contacts withstaple drivers 43 to drivewedge shape sledge 41, thisstaple drivers 43 drives a plurality ofpincers 47 of 51 outsides, pincers hole in nail box 37 conversely, to form on the inner surface ofchopping block 18 and bag 53 contact.Fig. 5 shows after finishing cutting and nail tissue, andfrizzen 14 is fully to distal translation.

Diaxon handle (Two-Axis Handle)

With reference to figure 6-7,handle portion 20 is made up of first and second substrate parts (base section) 50 and 52, and these two substrate parts are by polymeric material, and for example glass filled polycarbonate (glass-filledpolycarbonate) is molded.First substrate parts 50 is furnished with many cylindrical bolts 54.Second substrate parts 52 comprises many extendedparts 56, respectively has hexagonal apertures 58.Thiscylindrical bolt 54 is contained in thehexagonal apertures 58, and remains on this by frictional force, is used to keep the combination of first andsecond substrate parts 50 and 52.

Housing medicatedcap 60 has throughhole 62, is used to engageapparatus part 22 and it is rotated around the longitudinal axis.Housing medicatedcap 60 comprises the inwardlyoutstanding boss 64 that prolongs along at least a portion of through hole 62.Thisboss 64 is contained in thecannelure 66, and this cannelure forms at the proximal part of cutting outcover 32, thereby the rotation of housing medicatedcap 60 produces the rotation of closing cover 32.Can recognize thatboss 64 further connectsframework 34, and contact, thereby also realize their rotation with a part that triggers driver part 36.Therefore, end effector 12 (not shown among Fig. 3-4) is rotated with housing medicatedcap 60.

The near-end 68 offramework 34 passes housing medicatedcap 60, and is provided with circumferential groove 70, and this circumferential groove is engaged fromsubstrate parts 50 and the 52 flute profile fixedparts 72 that extend by corresponding.Only show the flute profile fixedpart 72 ofsecond substrate parts 52 among the figure.This flute profile fixedpart 72 stretches out fromsubstrate parts 50,52, be used forframework 34 is fixed to handleportion 20, thereby thisframework 34 not relatively handleportion 20 vertically move.

Close trigger 26 and havegrip member 74, gearedparts 76 and intermediate member 78.Hole 80 connects intermediate member 78.Close trigger 26 in order to install onhandle portion 20 in the mode that pivots, thecylinder support component 82 that extends fromsecond substrate parts 52 passes this hole 80.Thecylinder support component 83 that extends from second substrate parts passes thehole 81 of triggeringtrigger 28, is used in pivotally supported mode it being installed in handle portion 20.Incylinder support component 83, be provided withhexagonal apertures 84, be used to hold the gim peg (not shown) that extends fromfirst substrate parts 50.

Close yoke 86 and be embedded in thehandle portion 20, be used for moving back and forth therein, and this is closed yoke and provides fromclosing trigger 26 to closingcover 32 translation.Thesupport component 88 and thefixed part 72 that extend fromsecond substrate parts 52 support thisyoke 86 inhandle portion 20, this support component extends thegroove 89 that connects in theyoke 86.

Close the near-end 90 ofcover 32 and be furnished withflange 92, in thereception groove 94 that its snap-fit forms in thedistal portion 96 of yoke 86.The near-end 98 ofyoke 86 hastooth rest 100, and it engages by the gearedparts 76 of closing trigger 26.Therefore, when closing thepistol type handle 24 oftrigger 26 to handleportion 20 when moving,yoke 86 and closecover 32 and move to far-end compresses simultaneously with thespring 102 ofyoke 86 to the near-end skew.As described below,close cover 32 centrifugal motion and realizedchopping block 18, and this near-end of closing cover moves and realizes closing of chopping block to far-end and to the translation around pivot of theelongated channel 16 ofend effector 12.

By with thecomposition surface 128 interactional front surfaces 130 thattrigger trigger 28,close trigger 26 and be offset (forward biased) forward and arrive open position.Clamp first hook, 104, thefirst hooks 104 and rotate to the back aroundbolt 106 from the top inhandle portion 20, restriction triggers trigger 28 to the moving ofpistol type handle 24, and clamps its closed position up to closing trigger 26.Thishook 104 limits the action that triggers trigger 28 by engaging thelocking bolt 107 that triggers in the trigger 28.Thishook 104 also withclose trigger 26 and contact.Particularly, thishook 104 preceding outstanding 108 on theintermediate member 78 ofclosing trigger 26joint elements 110, outside 110holes 80 of joint elements, towards grip member 74.Hook 104 cuts out the direction skew of theparts 110 oftrigger 26 to contact, and engages thelocking bolt 107 that triggers in thetrigger 28 by retracting spring 112.When depressing when closingtrigger 26, thishook 104 moves rearwards from the top,compression retracting spring 112, this spring on thishook 104 backward outstanding 114 and release-push 30 on catch between outstanding 116 forward.

The near-end of closingtrigger 26 whenyoke 86 response moves and when far-end moved, the top of release-push 30door bolt arm 118 moved along the upper surface on theyoke 86 120, up to falling withinyoke 86 near-ends, in thegroove 122 that upwards exists in the lowerpart.Retracting spring 112 impels release-push 30 outside, and this button is pivotally lowered into thegroove 122 that upwards exists around topdoor bolt arm 118 and engages, and closes trigger 26 thereby clamp locking position at tissue.

By inwardly pushing away release-push 30,door bolt arm 118 can shift outgroove 122, to discharge chopping block 18.Particularly,door bolt arm 118 in top upwards rotates around thebolt 123 of second substrate parts 52.Then, allowingyoke 86 responses to close returning oftrigger 26 moves and moves to near-end.

Triggertrigger return spring 124 and be positioned in thehandle portion 20, an end of this spring is connected to thebolt 106 ofsecond substrate parts 52, and the other end is connected to thebolt 126 that triggers on the trigger 28.In order to triggertrigger 28,trigger return spring 124 and apply return force to bolt 126 in direction skew away from the pistol type handle 24 of handle portion 20.Close thecomposition surface 128 of the triggeringtrigger 28 oftrigger 26 front surfaces 130 by skew,close trigger 26 also away from 24 skews of pistol type handle.

When closingtrigger 26 when pistol type handle 24 moves, its front surface 130 engages withcomposition surface 128 on triggeringtrigger 28,causes triggering trigger 28 and moves to its " triggering " position.When at its trigger position, this triggeringtrigger 28 is arranged on the position of 24 one-tenth about 45s of relative pistol type handle.After pincers triggered,spring 124 caused triggeringtrigger 28 and returns its initial position.Return when mobile when triggeringtrigger 28, itscomposition surface 128 oppositely promotes to close front surfaces 130 oftrigger 26, causes closingtrigger 26 and returns its initialposition.Thrust parts 132 extend fromsecond substrate parts 52, to prevent thatclosing trigger 26 rotates above its initial position.

Surgical stapling andcutter sweep 10 also comprise reciprocatingmember 134, synergistic device (multiplier) 136 and driver part 138.This reciprocatingmember 134 comprises wedge shape sledge (wedge sled) or wedge shape sledge (not shown among Fig. 6-7) and themetal driving bar 140 in the apparatus part.

Driver part 138 comprises first and second tooth bars 141 and 142.First and second tooth bars, 141,142intermediary driver parts 138 are provided with first notch 144.Return when mobile triggeringtrigger 28, thetooth 146 that triggers on thetrigger 28 engages withfirst groove 144, is used for makingdriver part 138 return its initial position after clamping triggering.Second groove 148 is used at its non-trigger positionmetal driving bar 140 being locked onto the topdoor bolt arm 118 of release-push 30 in the close end location ofmetal driving bar 140.

Synergistic device 136 comprises the first and secondintegrated pinions 150 and 152.First tooth bar 154 that is equipped with onfirst pinion 150 and themetal driving bar 140 engages.Second pinion 152 engages withtooth bar 141 on the driver part 138.First pinion 150 has first diameter, andsecond pinion 152 has second diameter littler than first diameter.

Pivoting controller (Rotational Articulation Control)

With reference to figure 6-9, handleportion 20 best incorporated pivotingcontrollers 13, this pivoting controller rotatesapparatus part 22 around the longitudinal axis ofsurgical device 10, and engagementend portion effector 12 make it with the longitudinal axis at angle.Hollow rotatingdrive pipe 200 is concentrically positioned in closes in thecover 32, and operationally be coupled to actuation control bar 202,200 longitudinal axis rotate thereby the rotation ofactuation control bar 202 makes pipe, and cause vertical rotation, or being connected ofclosed loop 250 and end effector 12.This connection of closedloop 250 meets the degree of rotation and the direction of theactuation control bar 202 of being observed and being handled by the doctor.In described form, because the degree of rotation ofactuation control bar 202 is corresponding with the connection degree of the longitudinal axis ofbar 23, relation is man-to-man, and like this, the doctor can obtain clear and definite indication, should recognize and can select other angular relationship.

Pivotingcontroller 13 comprises that a pair of rotation transmitshousing 204, and they are fixed on the housing medicated cap 60.In addition, rotate to transmit theouter tab 206 thathousing 204 comprises vertical arrangement, this fin by the doctor reverse with realize rotating transmithousing 204 and therefore endeffector 12 rotate around the longitudinal axis of apparatus part 22.Actuation control bar 202 is connected tocylinder connector 208, and the common upward opening of this connector is positioned atcylindrical groove 210, and vertical and bar 23.The lowermost portion ofconnector 208 comprisestip 212, and this tip interlock enters near theopening 214 in theconnection transmission housing 208 ofbar 23, and thistip 212 prevents thatconnector 208 breaks away from fromcylindrical groove 210.

Cyclic gear teeth 216 is positioned at the bottom ofconnector 208, and is meshed withtooth 218 on the turn yoke 220.Turn yoke 220 is across closing on the connectionrectangular window 222 that forms in the cover 32.Closing cover 32 is slidably to move in pivoting controller 13 (vertically), to close and to open end effector 12.Rotatingdrive pipe 200 relatively rotatescontroller 13 and vertically moves with closing cover 32.Turn yoke window 222 provides the gap for theboss 224 that turnyoke 220 inwardly exists, and thisturn yoke 220 is passedrectangular window 222, to be bonded on thegroove 226 in therotating drive pipe 200, for rotating longitudinal register rotating drive pipe 200.Therotating drive pipe 200 of hollow in closingcover 32 fromlinkwork 11 longitudinal extensions, and to far-end end atclose overlap 32lock tab 227before.Fin 227 curves inwardly after the proximal end face of rotatingdrive pipe 200, thereby and keepsrotating drive pipe 200 inbar 23.

Should recognize to rotate and transmit the blanked-offpipe 35 thathousing 204 is operatively coupled to bar 23.External diametercircular groove 228 by near-end, this groove engages circular toinward flange 230 in the distal openings ofsubstrate parts 50,52, turn yoke pivoting controller housing medicatedcap 60 makesturn yoke 220 remain on connection and transmits in thehousing 60, and pivotingcontroller 13 is remained in thehandle portion 20.

Figure 10 and 11 illustrates thegear linkwork 11 of Fig. 1-2 withspur gear linkwork 240 forms, and this gear linkwork is with above-mentioned the same, but has additional rotating drive assembly on other limit oflinkwork 240, thereby improvesperformance.Linkwork 240 has rotating hollowrotating drive pipe 242, and it is arranged in blanked-offpipe 32 with one heart, and thislinkwork 240 has far-end projectingteeth wheel component 244 around first circumferential section 246.Gearedparts 244 engages from thespur gear 248 that closedloop 250 stretches out at near-end with being connected to handle, and this closed loop rotates around the bolt 253 that connects first and second pivoting points 252,260, and described pivoting point stretches out to far-end from closing cover 32.Thereby the rotation pivot line passes first and second pivoting point 252,260 and the bolts 253, and this bolt is coupled to closedloop 250 rotationally closes cover 32.Therotational engagement gear 242 and 248 ofdriver 242, and around first and second pivoting points 252,260 connection closedring 250.

In order to be increased in the effective surface area of the gear contact between hollowrotating drive pipe 242 and theclosed loop 250, secondcircumferential section 254 of hollowrotating drive pipe 242 has to the recessed projectingteeth wheel component 256 that extends therefrom of far-end.By thereverse gear 262 byframework 34 pivotal support, this gearedparts 256 operationally is coupled tospur gear 258, and this spur gear connects and be outstanding to near-end from the reverse side of closed loop 250.Reverse gear 262 at another side engagessecond spur gear 258 ofclosed loop 250 engaging to the recessed projectingteeth wheel component 256 of far-end on one side.

When closingtrigger 26 when activateding, close the hollowrotating drive pipe 242 ofcover 32 and move withnear chopping block 18 to far-end around pivotally connected blanked-offpipe 250boths.Pivot hole 264 by being pinned to spur gear 248,258 centers and 266 pivoting point 252,260, and theframe openings 264 that extends by the there, the blanked-offpipe 35 of closingcover 32 is away from closed loop 33.Frame openings 268 provides the gap, thereby the proximal edge of closedloop 33 and the remote edge of closing the blanked-offpipe 35 ofcover 32 can not collide when connecting.

Figure 11 shows apparatus part 270 with is olation, and this apparatus partly comprises spur gear linkwork 240.Framework 272 can vertically be connected to the handle portion 20 (shown in Fig. 1 and 2) that hasaxle sleeve 274 at its close end, and is longer than the triggeringadapter 280 of longitudinal sliding motion inframe slot 276 to alignedopening 278 formedframe slots 276 with the central longitudinal of framework 272.The close end of triggeringadapter 280 is the distal portion of jointing metal drive rod 140 (shown in Fig. 6) rotationally.The distal portion that triggersadapter 280 comprises thegroove 282 that holdsfrizzen 14 close ends, is connected therein by bolt 284.Location in thelow groove 286 of the more distal portions offrizzen 14 in the frizzen offluting guider 288, thisguider 288 engages withrotating frame parts 290 andframework 272 to far-end.

Theframe parts 290 that the joint connects has grapplingpassage component 292, and these parts are connected to theconnection collar 294 of the proximal part inelongated channel 16 to far-end.Frizzen 14 passes thelow groove 295 in the rotating frame parts 290.Joint connectingframe parts 290 away from the distal portion offramework 272, and are connected to the there for connecting byelastomeric connector 296 by the frizzen offluting guider 288 flexibly.Widening inclose end 298 engageframe 272 distal portion to the top that far-end is communicated with ofelastomeric connector 296 is recessed 300, and thedistal portion 302 of widening ofelastomeric connector 296 engages in the connectingframe parts 290 top recessed 304 to near-end is communicated with.Thereby though have flexible portion between it,elongated channel 16 is connected to handleportion 20.

Elongated channel 16 also has choppingblock cam path 306, thechopping block pivot 308 that holds choppingblock 18 that this cam path sways.Theclosed loop 250 that surrounds theframe parts 290 that the joint connects comprises thefin 310 that exists to far-end, and this fin engages nearest but is positioned at thechopping block part 312 ofchopping block pivot 308 far-ends on thechopping block 18, thereby realizes opening.When closedloop 250 moved forward, it was to the closed 314 contact tilted cylindrical envelope closeds 316 that far-end exists, and this face is positioned at the far-end of thefin 312 of chopping block 18.This cam action is closedchopping block 18 downwards, contacts the flat face ofcylinder 318 ofchopping blocks 18 up to the closed 314 ofclosed loop 250.

Gripper shoe

Figure 12-13 illustrates thelinkwork 240 around hinge pivot, andlinkwork 240 is betweenbar 23 andend effector 12, and thefrizzen 14 that cuts is flexible, is enough to the activity of rotating.The rotatingdrive pipeline 242 of hollow engages withspur gear 248 on the closed hoop 33.Omitted on this figure andclosed cover 32 proximal part 35 (being blanked-off pipe 35), this closes cover for the longitudinal register that is connected at thespur gear 248 ofupper pivot point 252 andlower pivot point 260.

Resiliency supported in thelinkwork 240 makes that this rotation can comprise a pair ofgripper shoe 400 and 402 about rotation pivot, and it is in the side of the proximal part offrizzen 14, bending when preventing that them from passing frame openings 268.Thereby, when frizzen 14 bendings, can transmit very big load.The proximal part offrizzen 14 triggers as the elongation taper is with 404 to illustrate, and this triggers one or more plain films of being with by spring material and forms, and this material is for arranging about rotation pivot is crooked.Thesetaper emission band 404 far-ends become thicker, describe as frizzenhead 406, and this far-end comprises margins ofexcision 48,top bolt 38,middle part bolt 46 and triggering pole cap 44 (bolt that dispenses in Figure 12).The thickness that thisthicker frizzen head 406 has increase is offset to prevent to produce in trigger process, thus the braking of guaranteeing effectively to excise and follow closely tube.By the near-end 408 oflinkwork 240 and far-end 410 one or all on introduce flexible cooperation,support plate 400 and 402 can favourablely reduce the influence of the emission load peak oftaper emission band 404.

As shown in figure 12, a pair ofsupport plate 400 and 402 respectively has near-end and far-end slip elastic ends 412 and 414, is received by theend frame bag 418 on theframe parts 290 offramework bag 416 in theframework 32 and joint connection respectively.When linkwork 240 connected, these twobags 416 and 418 reduced insideframe openings 268 for theelasticity terminal 412 and 414 onsupport plate 400 and 402 provides a gap, and outsideframe openings 268 extends.Crooked end effector 12 makes the position-reversed ofelastic ends 412 and 414 (not shown) in the other direction.As long as when near-end elastic ends 412 is tending towards the distalmost surface 420 of non-rigid bonded toframe bag 416, the peak value triggering bowing under load ground thatsupport plate 400 and 402 can respondfrizzen 14 moves to far-end.

In contrast, what Figure 14～15 were described is the holding components 421,422 of prior art, and it is made by spring material, and this spring material is connected to thenearside 423 of known linkwork 25 rigidly, and contacts with the distally 424 of this known linkwork slidably.Device in Figure 14 is to stretch or unbending, and the freedom of a pair ofsupport plate 421 and 422 or far-end 429 mediate inframework bag 418, and stiff end 427,428 is fixedly connected to nearside 423.According to shown in Figure 15, end effector is in bending position especially, and frizzen 426 and gripper shoe 421,422 are also being rotated bending.Because gripper shoe 421,422nd, elastic cantilever beam, they and frizzen 426 generations contacting as shown in the figure, the freedistal end 429 of gripper shoe 421,422 can be overlapped in 418 at framework and be moved to far-end or near-end respectively freely.The freedom of gripper shoe 421,422 or far-end 429 contact withfrizzen 426, required power in the time of can introducing tensile load and increasemobile frizzen 426.

Figure 16 shows gripper shoe 430,432, and inframe strip 418, each alternately respectively comprises the far-end 436 that a rigidly connected near-end 434 is connected with spring this gripper shoe, respectively holds 436 byopposite compression spring 438 joints.Far-end 436 springs are connected to the additional control thatframe strip 418 provides free distal end, reducing the pulling force offrizzen 14, and far-end 436 also can be vertically moved when crooked rotating.Mode as an alternative, the spring that provides bycompression spring 438 connects can be reverse, and near-end 434 is engaged with rigidly connected far-end 436.

Figure 17 shows the gripper shoe 430,432 of Figure 16 of theelastomeric element 440 that has each far-end 436 that engages each gripper shoe 430,432.Mode as an alternative, the elasticity that is formed byelastomeric element 440 connects and can change, and is about to near-end 434 and is rigidly connected with far-end 436.Elastomeric element can be by multiple elastomeric material, as silicones, and rubber, any formation of the perhaps how known rubber-like lactoprene of Buna n (buna-n).Foamed materials also can be used as spring, and can comprise by various materials, silicone foams for example, the foam of closing or open the chamber that forms based on the foam or the polyethylene of rubber.

Figure 18～19 show the gripper shoe 442,444 that comprises inside and outside flexural spring finger piece 446,448, the end of this spring finger spring ground engageframe bag 418, thus latch plate 442,444 absorbs the triggering load from frizzen 14.Mode as an alternative, along with the near-end that comprises inside and outside spring finger 446,448 nearly end frame bag 416 (not shown among Figure 18-19) engage with rigidly connected far-end 436, spring engages can be reverse.Figure 19 shows how to obtain additional flexibility by the opening of wherein introducing 450 along gripper shoe 442,444 spacings.

Figure 20 illustrates the gripper shoe 430,432 of Figure 16, and itsmiddle frame bag 416 hasrelative compression spring 438 withend frame bag 418, with the influence of further minimizing frizzen load (firing loads).

Figure 21 illustrates the gripper shoe 430,432 of Figure 17, and itsmiddle frame bag 416 and endframe bag 418 haveelastomeric element 440, with the influence of the triggering load of further minimizing frizzen.

Figure 22 shows gripper shoe 452,454, two spring fingers resilientengagement framework bag 416 and theend frame bag 418 that comprises inside and outside flexural spring finger piece 446,448 at both ends, with the influence of further minimizing frizzen load.

Figure 23 shows 456,458, two gripper shoes of elastic supporting plate engageframe bag 416 and endframe bag 418 respectively, with by response stretching, extension and compression thereunto, is adjusted at the variation in the interval on the frame openings 268.Elastic supporting plate can have flexible and elastic material by many, and these materials comprise: silicones, rubber, with base cloth receive n have elasticity or many known artificial rubber of rebound elasticity in any.

Figure 24 is the exploded view of low friction support plate 460,462, and described gripper shoe 460,462 is in conjunction with ball 464, to reduce the frictional force betweenfrizzen 14 and the gripper shoe 460,462.Gripper shoe 460,462 has recess 466 respectively, is used to hold ball 464, contacts withfrizzen 14 with in holding them in.Mode as an alternative, for the far-end offrizzen 14 moves, the cylinder ball can combine with the cylinder ball of guiding.

Although the present invention is described by the explanation to several embodiments, although and very at large described illustrative embodiment, and do not mean that the scope of the claim of will enclose limits or be restricted to by any way such details.Those of ordinary skill in the art can be readily seen that additional advantage and improvement.

The present invention is discussing aspect endoscopic procedure and the device.Yet, as used herein term for example " splanchnoscopy " should not be interpreted as with the present invention be defined as only be used for endoscope tube (that is the trocar) bonded surgical stapling and cutter sweep.Antithesis, should believe that the present invention can be applied in passage is defined as any process of little otch, comprise but be not limited to the laparoscopy process, also comprise the opening process.

Another example, though Eshape bar frizzen 14 is favourable for surgical cutting and the staplinginstrument 10 that splanchnoscopy adopts, less E shape bar also can be used in other clinical course.What people accepted usually is that endoscopic procedure is more common than laparoscopy process.Therefore, the present invention is discussing aspect endoscopic procedure and the device.Yet, as used herein term for example " splanchnoscopy " should not be interpreted as with the present invention be limited to only be used for endoscope tube (that is the trocar) bonded surgical fixation and device for excising.Antithesis, should believe that the present invention can be applied in passage is limited to any process of little otch, comprise but be not limited to the laparoscopy process, also comprise the opening process.

Another example, though illustrative handle portion described here 20 is manipulation by the doctor, some or all functions that drive handle portion with energy (for example wind-force, waterpower, motor machine, ultrasonic etc.) also are consistent with aspect of the present invention.In addition, can take the manual control of handle portion or remote control (for example wireless remote control, braking control station etc.) each control of these functions.

As other example, though advantageously described stitching simultaneously and cutter sweep here, but with the end effector of other types rotationally control connection also be consistent with aspect of the present invention, as grasper, cutter, stapling instrument, folder tucker, lane device, medicine/gene therapy transfer device and the energy device that uses ultrasonic, radio frequency (RF), laser etc.

For example, can use be rigidly connected, elasticity connects the various combinations in support plate end is connected with spring, the distal portion that is connected with spring of the close end of elasticity connection for example.

Claims (8)

1. surgical device, this transposition comprises:

The leader, operationally be arranged to rotate action and trigger action;

Have the bar of the longitudinal axis, be connected to handle portion, be used to impel rotational action and trigger action;

Linkwork is connected to end effector with described bar, and the response rotational action is around the longitudinal axis pivoting end effector of described bar;

Far-end is connected to the end effector of linkwork;

To the trigger mechanism that trigger action reacts, trigger mechanism is moved and is connected to linkwork and end effector, with the response trigger action; With

A pair of support plate is positioned at the both sides of trigger mechanism, strides across linkwork, and each gripper shoe comprises the end in the bonded to frame groove flexibly, and described frame slot forms in linkwork.

2. surgical device as claimed in claim 1 wherein also comprises a spring, and described spring vertically is connected to the selected side and the gripper shoe end of frame slot.

3. surgical device as claimed in claim 2, wherein other engaged at end of each gripper shoe and is setovered by spring in the end frame groove.

4. surgical device as claimed in claim 2, wherein said spring are included in the spring finger that the gripper shoe end forms.

5. surgical device as claimed in claim 4, wherein this spring finger distal orientation becomes the side towards frame slot, and gripper shoe comprises another spring finger, and described another spring finger near-end is oriented the opposite side towards frame slot.

6. surgical device as claimed in claim 1 wherein also is included in the frame slot and engages, and is coupled to the elastomeric element of this gripper shoe end.

7. surgical device as claimed in claim 6, wherein other engaged at end of each gripper shoe and is supported by another elastomeric element that is bonded on wherein in the end frame groove.

8. surgical device as claimed in claim 1, wherein each gripper shoe comprises that the response rotational action is to change the elastomeric material of longitudinal length.

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